Risk Factors Of Sarcopeniaand Osteoporosis In Hospitalized Elderly Patients With COPD

Objective:To understand the prevalence of concomitant sarcopenia and osteoporosis in hospitalized elderly patients with chronic obstructive pulmonary disease（COPD）,analyze their risk factors,explore the correlation between COPD and sarcopenia and osteoporosis,and effectively prevent the occurrence of sarcopenia and osteoporosis in the elderly.Methods:A total of 150 patients with stable COPD who were hospitalized in the First People’s Hospital of Xiangtan from October 2019to November 2020 were enrolled in this study,and general and clinical biochemical data were collected,and the skeletal muscle content of the extremities was measured by bioelectrical impedance analyzer and relative appendicular skeletal muscle mass（RASM）was calculated,followed by6-m daily gait speed test and grip strength test using dual-energy x-ray Bone densitometry was performed to determine bone mineral density（BMD）.The prevalence and risk factors of sarcopenia and osteoporosis in elderly patients with COPD were analyzed,and the percentage of forced expiratory volume in the first second（FEV₁%）,forced vital capacity（FVC）,forced expiratory volume in the first second（FEV₁）,FEV₁/FVC%and BMD,skeletal muscle mass,grip strength Correlation of 6 m daily walking speed.Results:1.The prevalence of comorbid sarcopenia in elderly COPD patients was 27.33%,and there was no gender difference in statistical analysis（p>0.05）.Compared with non-myasthenia gravis patients with COPD in the elderly,patients with sarcopenia were older,had lower body mass index（BMI）,blood calcium（Ca）,25-hydroxyvitamin D（25-（OH）D）,and a lower proportion of patients with combined type 2 diabetes（p<0.01）.One-way logistic regression analysis suggested that age was a risk factor for sarcopenia,and BMI,Ca,25-（OH）D,and type 2 diabetes were protective factors.Multi-factor unconditional logistic regression analysis incorporated all variables that were significant in the one-way logistic regression analysis and found that age（OR 1.071,p<0.01）was a risk factor and BMI（OR 0.729,p<0.01）,Ca（OR 0.030,p<0.01）,and25-（OH）D（OR 0.903,p<0.05）were protective factors.2.The prevalence of concurrent osteoporosis in elderly COPD patients was 56.00%,with 51.33%in men and 70.27%in women,and the difference in prevalence between men and women was statistically significant（p<0.05）.Compared with non-osteoporotic patients in elderly COPD patients,osteoporotic patients were older,had lower BMI,Ca,and25-（OH）D,and a lower proportion of combined type 2 diabetes（p<0.01）.One-way logistic regression analysis suggested that age and female were risk factors for osteoporosis,and BMI,Ca,25-（OH）D,and comorbid type 2diabetes were protective factors.Multi-factor regression analysis revealed age（OR 1.055,p<0.05）and female（OR 1.236,p<0.05）as risk factors,and BMI（OR 0.634,p<0.01）,Ca（OR 0.013,p<0.05）,and 25-（OH）D（OR 0.900,p<0.05）as protective factors.3.Grip strength,6 m daily gait speed,limb skeletal muscle mass,RASM,and BMD were significantly decreased in elderly COPD patients with sarcopenia compared with non-sarcopenic patients,and the difference was statistically significant（p<0.01）.FEV₁%,FVC,and FEV₁decreased in patients with sarcopenia compared with those with non-sarcopenia,and the difference was statistically significant（p<0.05）.Grip strength,6 m daily gait speed,skeletal muscle mass of the extremities,RASM,and BMD were significantly decreased in elderly COPD patients with osteoporosis compared with non-osteoporotic patients,with statistically significant differences（p<0.01）.FEV₁%,FVC,and FEV₁were significantly decreased in patients with osteoporosis compared with non-osteoporotic patients,which was statistically significant（p<0.01）.Correlation analysis method analysis suggested that FEV₁/FVC%,FEV₁%,FVC,FEV₁and BMD were positively correlated in elderly COPD patients（p<0.05）,and pulmonary function classification was negatively correlated with skeletal muscle mass of the extremities and BMD（p<0.05）.Conclusion:1.The prevalence of concurrent sarcopenia and osteoporosis may be higher in elderly COPD patients.2.Risk factors for the occurrence of sarcopenia in elderly COPD patients may include age,low BMI,low Ca,and low 25-（OH）D.3.Risk factors for concurrent osteoporosis in elderly COPD patients may include advanced age,female,low BMI,low Ca,and low 25-（OH）D.4.Elderly COPD patients had a positive correlation between FEV₁/FVC%,FEV₁%,FVC,FEV₁and BMD,and a negative correlation between pulmonary function severity grading and skeletal muscle mass of the extremities and BMD.